NHS Lothian, Edinburgh.
Gloucestershire Diabetic Retinopathy Research Group, Cheltenham General Hospital, Cheltenham.
Diabet Med. 2017 Jul;34(7):993-999. doi: 10.1111/dme.13350. Epub 2017 Apr 10.
To investigate variables at the demographic and primary care practice levels that influence the uptake of diabetic retinopathy screening.
Data were extracted from the management software of one screening programme for 21 797 people registered with 79 general practices. Uptake was examined by gender, age group, modality of screening (mobile unit at general practice versus high-street optometrist), and by general practice. A telephone survey of high-street optometrists provided information on the availability of screening appointments.
Uptake was 82.4% during the study period, and was higher for men (83.2%) than for women (81.5%) (P = 0.001). Uptake varied by age group (P < 0.001), being lowest in those aged 12-39 years (67%). Uptake was higher for people invited to a general practice for screening by a mobile unit (83.5%) than for those invited for screening by a high-street optometrist (82%) (P = 0.006). After adjusting for these factors and for socio-economic deprivation score at the location of the general practice, heterogeneity in uptake rate was still observed between some practices. Our survey of optometrists indicated wide variation in the availability of time slots for screening during the week and of screening appointment provision.
Diabetic retinopathy screening services do not achieve high uptake among the youngest or oldest age groups. Practices in the least deprived areas had the highest uptake. Variation in uptake between general practices after adjustment for individual-level variables and deprivation suggests that practice-level factors may have an important role in determining rates of screening attendance.
调查人口统计学和初级保健实践层面的变量，这些变量会影响糖尿病视网膜病变筛查的参与度。
从一个筛查项目的管理软件中提取了 79 家全科诊所 21797 名登记患者的数据。通过性别、年龄组、筛查方式（全科诊所的移动单位与高街验光师）以及全科诊所来检查参与度。对高街验光师进行了电话调查，以了解筛查预约的可用性。
在研究期间，参与度为 82.4%，男性（83.2%）高于女性（81.5%）（P=0.001）。参与度因年龄组而异（P<0.001），12-39 岁年龄组的参与度最低（67%）。通过移动单位邀请全科诊所进行筛查的人群的参与度（83.5%）高于通过高街验光师邀请进行筛查的人群（82%）（P=0.006）。在调整了这些因素以及全科诊所所在地的社会经济剥夺评分后，一些诊所之间仍存在参与率的异质性。我们对验光师的调查表明，在一周内的时间段和筛查预约提供方面，筛查时间的可用性存在很大差异。
糖尿病视网膜病变筛查服务在最年轻或最年长的年龄组中并未达到高参与度。最不贫困地区的实践具有最高的参与度。在调整了个体层面变量和剥夺程度后，全科诊所之间的参与度差异表明，实践层面的因素可能在决定筛查参与率方面发挥重要作用。
